Employee Showcase LD

Employee Showcase LD

Personal Information

Position Information

Reporting Manager:    Start Date (Company):

Showcase Content & Consent

Short professional biography (to be used verbatim in internal communications and program materials). Employee should provide a concise, factual summary of role, responsibilities, and leadership focus.

I consent to the use of my name, job title, photograph, video, written biography, and project descriptions in internal communications, leadership development materials, and company presentations.

I authorize use as described above and confirm I hold necessary third-party permissions for referenced content.

Leadership Development (LD) Participation

Please indicate leadership development areas of interest (select all that apply):

Strategic Leadership    People & Talent Leadership    Operational Excellence

Willing to serve as a mentor in the program

Employment History (Most Recent First)

Title:    From:    To:

Title:    From:    To:

Education

Graduation Date:

Professional References

Phone:    Email:

Phone:    Email:

Phone:    Email:

Legal Disclosures & Authorizations

At-Will Employment: Nothing in this Employee Showcase submission alters the at-will nature of employment. Either the Company or the Employee may terminate employment at any time with or without cause and with or without notice, except as otherwise provided by law or a separate written agreement signed by an authorized company representative.

Equal Employment Opportunity: The Company is an equal opportunity employer. Participation in leadership development and internal showcases is not conditioned on protected status; selection criteria are based on legitimate business considerations.

Authorization to Verify: I authorize the Company and its designated agents to verify the accuracy of the information I have provided. This authorization includes contacting prior employers, education institutions, references, and any third parties who can verify my background and qualifications. I understand that verification may include a review of employment dates, positions held, performance, and separation reasons.

I authorize the Company to contact prior employers, references, and educational institutions to verify my statements.

Background Checks: For certain leadership development placements, the Company may require background checks relevant to the position or program. By signing below I consent to background checks as permitted by law where required for program participation.

I consent to background checks if required for program participation.

Data Use, Retention, and Revocation

The Company will retain materials submitted for internal use consistent with business needs and applicable law. The Company will not sell or distribute personal information outside authorized internal channels. Employees may request revocation of consent to future uses of showcase materials; revocation will not affect materials already published or used prior to revocation.

I acknowledge understanding of the data use and retention policy set out above.

Applicant Certification

I certify under penalty of perjury that the information provided in this Employee Showcase LD form is true, complete, and accurate to the best of my knowledge. I understand that false or misleading statements are grounds for disciplinary action up to and including termination of employment. I further acknowledge that participation in the showcase and leadership development activities does not in itself constitute a promotion, change in compensation, or guarantee of continued participation.

I authorize the use of the provided materials and release the Company and its agents from claims arising from authorized use of my submitted materials in internal communications and leadership development programming, except where prohibited by law.

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